Thrombotic Complications of Tunneled Central Lines in Children With Malignancy

Abstract

The total rate of thrombotic complications in children with TCL and malignancy is high. A substantial proportion of thrombotic complications can be clinically silent. The use of a heparin lock once a week seems far from effective in preventing thrombotic events in patients with TCL. The TCL life span has no influence on the rate of thrombotic events.

Prevalence of Symptomatic and Asymptomatic Thrombosis in Pediatric Oncology Patients With Tunneled Central Venous Catheters

“…The prevalence of asymptomatic CVC‐related VTE in our cohort was also lower compared to previous studies investigating asymptomatic CVC‐related VTE (Table ) . Two studies investigated asymptomatic CVC‐related VTE in patients who had their CVC removed .…”

“…The prevalence of asymptomatic CVC-related VTE in our cohort was also lower compared to previous studies investigating asymptomatic CVC-related VTE (Table IV). [2,10,14,[17][18][19][20][21] Two studies investigated asymptomatic CVC-related VTE in patients who had their CVC removed. [2,21] However, the reason of CVC removal may have been (related to) CVC-related VTE, resulting in a potential selection of patients with an increased risk of VTE.…”

Thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience

“…One exception may be the treatment with asparaginase used in leukemia and lymphoma treatment protocols. Up to 25% of all thrombotic events are reported after L-asparaginase infusion and during treatment with corticosteroids [ 35 ]. Among the leukemia patients with CVC-associated VTE, 40% developed thrombosis within the temporal context of asparaginase medication.…”

“…Without prophylactic anticoagulation, children with CVC-related VTE frequently experience recurrent catheter complications, including re-thrombosis (up to 60%), deep vein thrombosis (DVT; up to 10%), and catheter-associated infections (30%) [ 7 , 39 ]. The use of prophylactic anticoagulation after CVC-associated thrombosis or VTE (LMWH or oral anticoagulants) seems to decrease the rate of re-thrombosis [ 20 , 21 ] and this subject should be discussed and further investigated [ 35 , 38 , 39 ].…”

Antithrombotic Therapy in Neonates and Children

“…447 More than 40% of children with cancer had CVAD occlusions despite weekly heparin locks. 525 In the hemodialysis setting, alteplase 1 mg/mL was shown to be more effective than heparin 5,000 units/mL in reducing intraluminal clot between hemodialysis sessions. 526 A multicenter study of 577 pediatric cancer patients with CVADs reported that urokinase administration every 2 weeks reduced both CVAD occlusion rates and catheterrelated infections compared with heparin administration.…”